ATTACHMENT 1 ACCEPTABLE WASTES I. WASTE MANAGEMENT PROCEDURES 1.0 DESCRIPTION OF WASTE A. Acceptable Wastes The medical waste processed at the facility is solid waste generated in healthcare or healthcare-related facilities, animal care, and research, pharmaceutical manufacturing and distribution facilities. The facility also processes special waste streams approved by the Division of Waste Management and Radiation Control. Typical wastes include paper, plastic, cloth, diagnostic cultures, human and animal tissues generated by hospitals, nursing homes, clinics, and other medical, dental and veterinary facilities; and expired and unused pharmaceuticals. Regulated medical waste is generally defined as any waste that can cause an infectious disease or that reasonably can be suspected of harboring human pathogenic organisms. It is also known as red bag waste, infectious waste, potentially infectious waste, biomedical waste, and biohazardous waste. Regulated medical waste includes single-use disposable items such as needles, syringes, gloves, and laboratory, surgical, emergency room and other supplies, which have been in contact with blood, blood products, bodily fluids, cultures or stocks of infectious agents. The following wastes are acceptable at the Stericycle facility: Wastes, including regulated medical wastes that are generated in the diagnosis, treatment, or immunization of humans or animals or related research, in the production/testing of biological materials (vaccines), and in the preparation and administration of chemotherapy waste, including waste defined by federal, state and local laws as medical, biohazardous, biomedical, infectious, and other wastes identified below: 1 Biohazardous waste including pathological waste: 2 Laboratory waste including: Cultures – medical/pathological Cultures/stocks of infectious agents – research and industrial Vaccines and related waste generated in the production thereof Page 1 Microbiologic specimens and related waste 3 Surgical specimens/tissues, contaminated animal parts, tissues, carcasses or body fluids 4 Fluid blood/blood products, containers/equipment and exudates, secretions, body fluids including, but not limited to, isolation waste 5 Sharps waste including, but not limited to: Needles, syringes, blades, needles with attached tubing, disposable surgical instruments Medical/laboratory glassware including slides, pipettes, blood tubes, blood vials, contaminated broken glass 6 Other medical waste as required by the infection control staff, physician, veterinarian or local health officer to be isolated and handled as regulated medical waste. 7 Trace-contaminated chemotherapy (antineoplastic/cytotoxic drugs) waste: Gowns, gloves, masks, barriers, IV tubing, empty bags/bottles, needles and syringes, empty drug vials, spill kits, and other items generated in the preparation and administration of antineoplastic drugs 8 Other Wastes: Expired and unused pharmaceuticals Confidential records / proprietary packaging and products Contraband (e.g. police evidence) Agriculture (APHIS) Waste, including Regulated Garbage from domestic and international sources Outdated, off-specification or unused consumer commodities Recalled or outdated disposable medical equipment or supplies 9 Sharps and I.V. tubing and bags/bottles which are being discarded and are considered incidental to preparation and administration of the drugs. Page 2 10 Intravenous tubing, bags, bottles, vials and syringes used in chemotherapy preparation and administration that contain only residual amounts of antineoplastic drugs. 11 “Municipal solid waste” as defined by UAC R315-302-2 (46) contaminated with potentially infectious materials 12 Other non-hazardous waste as approved by the Division of Waste Management and Radiation Control. 13 Special wastes (as defined by UAC R315-302-2 include): Furniture contaminated with potentially infectious materials Infectious waste Dead animals B. Estimated Annual Quantities: The maximum incineration capacity of the facility is 4,110 pounds per hour averaged. This estimated quantity accounts for up to two incinerators. The estimated annual maximum quantity of waste incinerated at the facility is approximately 18,000 tons per year. C. Areas Served by Facility: This facility serves the greater Salt Lake City area as well as the entire state of Utah. As part of Stericycle’s business network, this facility also services various markets throughout North America. The primary market served is Stericycle’s Western Regional system, including but not limited to the Pacific Coast and Intermountain States. D. Non-conforming Waste: Non-conforming waste will not be accepted for treatment and includes: 1. Chemical materials which are regulated as hazardous waste under RCRA or UAC Subsection 19-6-102 (10) and Section R315-2-3; 2. Complete human remains (e.g., that include head and/or torso), cadavers, and fetal remains; (Stericycle will not accept recognizable fetal remains);; 3. Compressed gas cylinders and canisters (including aerosol cans); 4. Radioactive materials (as outlined in Section 3); Page 3 5. Explosive materials; 6. Bulk cytotoxic materials; 7. Full or partially full I.V. bottles/bags and vials of chemotherapy agents that constitute a hazardous waste. A copy of Stericycle’s Waste Acceptance Protocol is provided as an attachment to this application. Any waste that is outside of the bounds of approved wastes must go through prior authorization by the State. E. Waste Tracking: Stericycle, Inc. currently employs a tracking system in which waste containers are labeled with the generators’ unique codes and tracked. Containers of waste are labeled and entered into the waste tracking system. Containers are picked up from the customer and taken to Stericycle treatment and/or logistics centers where the waste is accordingly treated or forwarded for treatment. Waste that is disposed via incineration at Stericycle is received and entered into our tracking system as part of the incineration process, allowing tracking of waste from pickup at the generator to final treatment. F. Waste Screening Procedures and Policies: Waste acceptance, screening procedures and guidelines are outlined in Section III-Waste Acceptance Protocol. 2.0 WASTE HANDLING AND STORAGE A. Container Management: 1. Waste Receiving/Storage: Typically, drivers load waste designated for management at Stericycle that is packaged at customers’ facilities. Waste is transported to Stericycle’s facility. Collection and transport vehicles arriving at the facility are directed either to an unloading dock or to a holding area. When directed or scheduled, vehicles are moved from the holding area to the unloading docks. Waste received will be disposed within 30 days from the day of pickup as listed on the shipping manifest. Page 4 If infectious waste is to be stored longer than seven days prior to processing, it must be stored at or below 40 degrees F (5 C). Waste received may be determined by Stericycle management to be consolidated and/or shipped to other facilities based on capacity, costs, customer needs, company policy, and/or waste properties. 2. Requirements to control pests and disease vectors are outlined in Section XII. B. Container Management Practices: 1. Container Flow in Management Area: Incoming waste containers are removed from vehicles onto the dock allowing adequate aisle space for workers to move about the receiving area and to allow for periodic cleaning. Containers of waste for processing or transfer may be staged on the south dock, in the building, or on the truck. Containers may not be staged outside of these areas. Closed containers may be transferred from the processing area of the building for staging in the dry storage or other indoor areas of the building. Waste received for treatment or transfer is weighed and screened for radiation, and the weight transfer and treatment is entered into the waste tracking system. When non-conforming waste is encountered (e.g., waste labeled as hazardous waste, radioactive waste, compressed gas containers, containers of chemicals, or other non-conforming waste), the container of non-conforming waste is logged into the operating record as non-conforming waste and is taken to the non- conforming waste storage area where it awaits transport for further management elsewhere. 2. Container Handling: Containers are loaded into the incinerator using loaders, forklifts, conveyors, and/or manually. Containers and/or lids may be washed out above the incinerator feed system, within a designated container wash area, or using a container wash system. Page 5 An operator may mix the waste containers and materials fed into incinerator as needed to achieve BTU and/or operational parameters. 3. Decanting of Containers: Containers and bags of waste may be decanted/consolidated into other containers (e.g., macro bins) for subsequent management either on site or at another facility following transport. 4. Reusable Containers Rigid reusable containers are available to Stericycle customers as a means of reducing exposure to blood borne pathogens. Reusable containers reduce the risk from leaking, soiled and/or mis- packaged boxes. Reusable containers also reduce the risk of needle-stick and sharps-type injuries. 5. Disinfection of Reusable Containers The reusable containers are disinfected after each use. Reusable containers are disinfected as outlined in 5.1, Section XII, Control of Disease Vectors. 6. Waste Containers Various waste containers (of different kinds, sizes, and configurations)